加味葛根芩连汤治疗新诊2型糖尿病痰(湿)热互结证临床研究  

Clinical Study of Modified Gegen Qinlian Tang for Newly-Diagnosed Type 2 Diabetes Mellitus with Syndrome of Binding of Phlegm and(Dampness)Heat

作　　者：王磊 WANG Lei

机构地区：[1]宁波市中医院内分泌科,浙江宁波315000

出　　处：《新中医》2021年第12期16-20,共5页New Chinese Medicine

摘　　要：目的:观察加味葛根芩连汤辨治痰(湿)热互结证新诊2型糖尿病(T2DM)的临床疗效及对脂肪细胞因子的影响。方法:将100例新诊T2DM患者随机分为观察组和对照组,各50例。对照组随餐服用盐酸二甲双胍片治疗,观察组在对照组基础上加服加味葛根芩连汤治疗,疗程均为3个月。检测治疗前后2组患者空腹血糖(FBG)、餐后2 h血糖(P2hBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)水平及胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(InISI)、胰岛β细胞功能指数(HOMA-β);计算治疗后FBG、HbA1c达标率;检测治疗前后总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)水平;检测治疗前后脂联素、抵抗素和瘦素等脂肪细胞因子水平;并进行治疗前后痰(湿)热互结证积分。结果:与同组治疗前比较,治疗后2组FBG、P2hBG、HbA1c、HOMA-IR、TC、TG、LDL-C、瘦素、抵抗素及痰(湿)热互结证积分均下降(P<0.01),FINS、HOMA-β、InISI、HDL-C及脂联素均升高(P<0.01)。与对照组治疗后比较,观察组治疗后FBG、P2hBG、HbA1c、HOMA-IR、TC、TG、LDL-C、瘦素、抵抗素及痰(湿)热互结证积分均较低(P<0.01),FINS、InISI、HOMA-β、HDL-C、脂联素及HbA1c达标率均较高(P<0.01,P<0.05)。结论:在二甲双胍治疗的基础上,给予加味葛根芩连汤内服干预痰(湿)热互结型新诊T2DM患者,能调节患者的糖脂代谢,改善临床症状,提高HbA1c达标率,减轻患者的糖毒性和脂毒性,在控制血糖的同时,可调节脂肪细胞因子,改善胰岛素抵抗,提高胰岛素敏感性和胰岛β细胞功能。Objective:To observe the clinical effect of modified Gegen Qinlian tang in the treatment of newly-diagnosed type 2 diabetes mellitus(T2DM)with syndrome of binding of phlegm and(dampness)heat,and its effect on adipocytokines.Methods:A total of 100 cases of patients with newly-diagnosed T2DM were randomly divided into the observation group and the control group,50 cases in each group.The control group was given oral administration of metformin hydrochloride tablets taken with food,the observation group was additionally treated with modified Gegen Qinlian tang based on the treatment of the control group.Both groups were treated for three months.Before and after treatment,levels of fasting blood glucose(FBG),postprandial 2 h blood glucose(P2hBG),hemoglobin A1c(HbA1c),and fasting insulin(FINS),homeostatic model assessment of insulin resistance(HOMA-IR),insulin sensitivity index(InISI),homeostasis model assessment ofβ-cell function(HOMA-β)were detected in the two groups.After treatment,the standard-reaching rates of FBG and HbA1c were counted.Before and after treatment,levels of total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)were detected;levels of adipocytokines,such as adiponectin,resistin and leptin,were detected;the score of the syndrome of binding of phlegm and(dampness)heat was recorded.Results:After treatment,when compared with those in the same group before treatment,levels of FBG,P2hBG,HbA1c,HOMA-IR,TC,TG,LDL-C,leptin,resistin as well as the score of the syndrome of binding of phlegm and(dampness)heat in the two groups were decreased(P<0.01),and the levels of FINS,HOMA-β,InISI,HDL-C,and adiponectin were increased(P<0.01).After treatment,when compared with those in the control group,levels of FBG,PBG,HbA1c,HOMA-IR,TC,TG,LDL-C,leptin,resistin,as well as the score of the syndrome of binding of phlegm and(dampness)heat in the observation group were lower(P<0.01),and the levels of FINS,HOMA-β,InISI,HDL-C,adiponectin,and the compli

关 键 词：2型糖尿病 加味葛根芩连汤 新诊 痰(湿)热互结证 胰岛素抵抗 胰岛Β细胞 脂肪细胞因子 

分 类 号：R587.1[医药卫生—内分泌]